Organization
POLLIWOG DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A TARVER DMD (OWNER)
(863) 899-1617
Entity
Organization
Contact information
Practice address
255 SE 17TH ST, OCALA, FL 34471
(352) 274-9731
(352) 274-9731
Mailing address
255 SE 17TH ST, OCALA, FL 34471
(352) 274-9731
(352) 274-9731
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN18670
FL
Other
Enumeration date
08/17/2011
Last updated
08/15/2012
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